Ovarian Cancer Flashcards
Q: What is the strongest risk factor for the development of ovarian cancer?
A: The strongest risk factor for ovarian cancer is a family history of ovarian cancer, particularly mutations in the BRCA1 and BRCA2 genes. Lynch syndrome (hereditary nonpolyposis colorectal cancer, HNPCC) is also associated with an increased risk.
Q: What are the most common histological subtypes of ovarian cancer?
A: The most common histological subtypes of ovarian cancer are serous cystadenocarcinoma (most common), mucinous cystadenocarcinoma, endometrioid carcinoma, and clear cell carcinoma. Serous cystadenocarcinoma is the most common and is often bilateral.
Q: What protective factors are known to reduce the risk of ovarian cancer?
A: Oral contraceptive use, multiple pregnancies, breastfeeding, and tubal ligation are known protective factors that reduce the risk of ovarian cancer by decreasing the number of ovulatory cycles
Q: What are the typical clinical features of ovarian cancer?
A: Ovarian cancer often presents with vague and non-specific symptoms such as abdominal distension or bloating, pelvic pain, early satiety, and urinary frequency. These symptoms are often mistaken for gastrointestinal issues, leading to delayed diagnosis.
Q: Which tumor marker is most commonly associated with ovarian cancer, and how is it used clinically?
A: The tumor marker CA-125 is most commonly associated with ovarian cancer, particularly in epithelial ovarian cancer. It is used for monitoring treatment response and detecting recurrence, but it is not specific enough for screening in the general population.
Q: What is the typical spread pattern of ovarian cancer?
A: Ovarian cancer typically spreads by direct extension to adjacent pelvic organs, transcoelomic spread through the peritoneal cavity, and lymphatic spread to the pelvic and para-aortic lymph nodes. Hematogenous spread is less common but can occur to the liver or lungs.
Q: What is the standard treatment approach for advanced-stage ovarian cancer?
A: The standard treatment for advanced-stage ovarian cancer includes surgical debulking (cytoreductive surgery) followed by platinum-based chemotherapy (e.g., carboplatin and paclitaxel). The goal of surgery is to remove as much of the tumor as possible.
Q: What is the significance of BRCA1 and BRCA2 mutations in ovarian cancer?
A: BRCA1 and BRCA2 mutations significantly increase the lifetime risk of developing ovarian cancer and are associated with a better response to PARP inhibitors due to the role of these genes in DNA repair.
Q: How does Lynch syndrome (HNPCC) increase the risk of ovarian cancer?
A: Lynch syndrome, caused by mutations in mismatch repair genes (e.g., MLH1, MSH2), increases the risk of ovarian cancer along with other cancers such as colorectal and endometrial cancer. Women with Lynch syndrome may undergo prophylactic oophorectomy to reduce risk.
Q: What are the complications associated with advanced ovarian cancer?
A: Complications of advanced ovarian cancer include bowel obstruction, pleural effusion, ascites, and malignant cachexia. These complications often result from peritoneal carcinomatosis and widespread metastasis.
